It follows an announcement by Scotland’s Chief Dental Officer Tom Ferris, who has a three-phase plan for the remobilisation of NHS dental services.
Thanking dental teams across Wales for their ‘efforts and hard work during the course of the pandemic thus far’ for their ‘agile and inspirational’ response, CDO Colette Bridgman outlined a phased return to practice.
The first stage in this process is planning for the de-escalation from the current RED alert phase to a heightened AMBER phase in dentistry, which will involve ‘continuation and strengthening of the provision in UDCs for those in need of AGPs’.
The second stage will need to address the backlog of need for patients and those people who do not normally attend dentistry routinely. This will include provision of definitive care for those who have received urgent care in the UDCs, those who have contacted dental practices during the RED alert phase, because they have had a dental problem and/or pain or swelling and who have an on-going treatment need. It will in addition, include those who did not meet the strict criteria for urgent or emergency care, but who have dental problems or treatment need that has had to be delayed, postponed or self-managed during this period of service interruption.
The third stage would be to reinstate routine assessment and care.
Additionally, Units of Dental Activity (UDAs) could become Units of Dental Assessment (UDAS) to ‘assess’ and meet need, address risk and maintain oral health, rather than just incentivise check-ups and treatment activity.
In her letter to the profession, CDO Colette Bridgman writes: ‘From 1 July to 30 September 2020, practices with NHS contracts will receive 90% of their Annual Contract Value (ACV). This reflects the reduced material and laboratory expenses, but we acknowledge that PPE could also present an additional cost, so we have provided an uplift from the current level of 80%. Going forward, some adjustment may be required in contracts that were underperforming due to recruitment difficulties prior to March 2020 and/or in those who have made staff redundant since March 2020.’
Standard Operating Procedures are in development to promote:
- Efficient use of appropriate PPE for both UDCs and practices
- Pre-appointment checks (by phone/videoconference)
- Pre-treatment checks
- Social distancing (consideration to timing of appointments and reduction in the number of patients in the waiting areas)
- Spacing of clinical appointments (reduction of numbers of patients waiting and providing sufficient time in-between appointments needed for adequate disinfection of the surgical areas).
The CDO concludes: ‘This is a time for the dental community to come together and collectively care for the population’s oral health needs in this exceptional context. The collaborative teamwork in dentistry in Wales in response to COVID-19 pandemic is unparalleled and I have no doubt that will continue in the coming year.’
For details, visit https://awfdcp.ac.uk/covid-19/official-comms
Meanwhile, Scotland’s phased return includes:
Phase 1: Increasing Capacity of Urgent Dental Care Centres (UDCCs)
Phase 2: Restarting Dental Practices
Phase 3: Introducing AGPs to Dental Practices/
The Scottish Government is also seeking ways to effectively test for COVID-19 and suggest that, as part of the phased remobilisation of NHS dental services, practices will be asked to support these programmes.
In a letter to dentists, the CDO for Scotland acknowledged that ‘an item of service model is not the most appropriate vehicle of financial remuneration during this period of reduced activity. We are therefore looking at alternative models of funding that will provide a more sustainable income level during this unusual period. In the meantime, we will look at appropriate NHS financial support measures for each phase of recovery’.
The CDO for England Sara Hurley is yet to outline a strategy for a return to work.